運用認知行為治療改善一位精神分裂病患強迫症狀之護理經驗

Nursing Experience of Applying Cognitive-Behavior Treatment to Assist a Schizophrenic Patient in Improving Obsessive and Compulsive Symptoms

林雅萍(Ya-Ping Lin) ； 侯淑英(Shu-Ying Hou) ； 余靜雲(Ching-Yun Yu)

《高雄護理雜誌》 26卷1期 (2009/05) Pp. 53-64

https://doi.org/10.6692/KJN-2009-26-1-5

摘要

本文主要是描述一位精神分裂症並合併強迫症狀之個案，在社區復健中心庇護性工作隊做職業功能訓練，但因強迫思考及強迫行為嚴重影響其工作表現、人際關係。筆者於95年5月2日至8月3日照護期間，透過整體性護理評估，發現其護理問題有知覺感受變異及思考過程紊亂。結合護理過程並配合認知行為治療技巧，如「蘇格拉底對話」、「向下追問法」及「暴露／不反應法」等，擬定護理治療計劃。經過三個月的護理，個案能夠學習到降低幻聽干擾的方法並減少強迫行為。症狀改善後個案能晉升至高階工作隊繼續復健。

關鍵字

精神分裂症 ； 強迫行為 ； 認知行為治療

並列摘要

This case report describes the use of cognitive-behavior treatment for a schizophrenic patient with obsessive and compulsive symptoms a community rehabilitation center. Because of the presenting symptoms, the patient could not work well and had frequent conflicts with friends and family. Cognitive-behavior treatment strategies such as the Socratic dialogue, downward arrow technique, and the exposure-based approach were used to modify the obsessive and compulsive symptoms of this patient. After 3 months of nursing care, the psychotic symptoms improved markedly. The result suggests that using cognitive-behavior treatment in schizophrenic patients with obsessive and compulsive manifested behaviors is effective.

並列關鍵字

schizophrenia ； obsessive and compulsive symptoms ； cognitive-behavior treatment